Cosmetic surgery and procedures reform: what you need to know

The reforms

There are five main areas of change underway to how cosmetic surgery and procedures are regulated:

• Revised Medical Board guidelines for practitioners performing cosmetic surgery and procedures.
• New Medical Board guidelines for practitioners advertising cosmetic surgery.
• An endorsement of registration for cosmetic surgery – which medical practitioners will be able to apply for, once there are approved qualifications by the Medical Board.
• Standards for accreditation of facilities – currently under consultation and part of the work on a national licensing framework for facilities where cosmetic surgery is performed.
• Legislative change to restrict who can use the title ‘surgeon’ – the Health Practitioner Regulation National Law (Surgeons) Amendment Bill 2023 is currently before parliament and is likely to be passed in August.

These changes follow the decision by Health Ministers in September 2022 to instigate a suite of reforms to improve safety in the cosmetic surgery industry, and associated consultations. Avant has welcomed the opportunity to contribute to these consultations, providing detailed submissions in the interests of our members and membership.

What is changing and when?

The Medical Board’s revised cosmetic guidelines and new advertising guidelines come into effect on 1 July 2023. Briefly, some of the new requirements include:

• patients seeking cosmetic surgery must have a referral from their usual GP, another GP or non-GP specialist. Examples of cosmetic surgery provided by the Medical Board include breast augmentation, abdominoplasty, rhinoplasty, blepharoplasty, surgical face lifts, cosmetic genital surgery, and liposuction and fat transfer
• practitioners performing the surgery or procedure must conduct a psychological assessment of the patient – and for surgery, this must be using a validated tool
• for surgery, at least two pre-operative consultations, at least one of which must be in person with the medical practitioner who will perform the surgery. The first consultation must be with the practitioner who will perform the surgery or another registered health practitioner who works with that practitioner
• for non-surgical procedures, medical practitioners must have a consultation with the patient (either in person or by video) each time they prescribe a Schedule 4 injectable.

The registration standard relating to the endorsement of registration for cosmetic surgery also comes into effect on 1 July 2023. Supporting this, standards for the accreditation of cosmetic surgery programs of study have been set by the Australian Medical Council. However, with qualifications still to be approved, practitioners won’t be able to apply for endorsements until a later date. This date is yet to be set by the Medical Board.

A public education campaign to promote safe and informed choices about cosmetic surgery and procedures has also begun. While the full extent of this campaign remains to be seen, resources are already publicly available and patients may bring these to your attention.

Other areas of reform regarding facilities accreditation and legislative change to restrict use of the title ‘surgeon’ are yet to be finalised. We continue to monitor and engage on these and will keep you informed.

What do you need to do?

If you are performing cosmetic surgery (no matter what you call yourself), or if you are operating a cosmetic surgery practice, the revised cosmetic guidelines and new advertising guidelines from the Medical Board apply to you. You need to read the guidelines and familiarise yourself with the new requirements and make the necessary changes, for example to your practice procedures and any advertising, and do so before 1 July 2023.

If you are performing non-surgical cosmetic procedures or running a cosmetic practice, parts of the revised cosmetic guidelines from the Medical Board also apply to you. These guidelines are broken down into two sections, the second of which addresses non-surgical procedures. You also need to read the guidelines and familiarise yourself with the new requirements and make the necessary changes before 1 July 2023.

If you are a referring practitioner (GP or non-GP specialist), the revised guidelines may also apply to you. This is because the revised guidelines contain a new requirement that any patient seeking cosmetic surgery must have a referral. That referral is ideally from their usual treating general practitioner but can also be from another general practitioner or other non-GP specialist practitioner.

The Medical Board has published FAQs about the referral requirement, which are being updated intermittently. Some aspects that the Board has already clarified include:

• the purpose of the referral is to provide information about the patient’s history
• doctors can decline a patient’s request for a referral, and should explain to the patient why they’re doing so
• the doctor providing the referral should review Ahpra’s public register to check the registration status of the doctor to whom they’re referring the patient
• the referring doctor is not responsible for discussing the surgery sought by the patient with them in detail and is not responsible for conducting the psychological assessment.

The Medical Board has also published a series of FAQs about other aspects of the guidelines. These are the best first port of call if you have any questions.

What’s next?

We’ll continue to engage with the Medical Board and keep you updated as further changes come into effect, so watch this space.

In the meantime, we encourage everyone to read the revised cosmetic guidelines and new advertising guidelines as they apply to you.

Resources

• Medical Board of Australia’s Guidelines for medical practitioners who perform cosmetic surgery and procedures.
• Medical Board of Australia’s Cosmetic surgery advertising obligations under the National Law.
• Avant webinar: current medico-legal issues